Sexually transmitted diseases at all-time high

By Nick Gier
Reader Columnist

The Centers for Disease Control has just released preliminary data on sexually transmitted diseases (STDs), and they show a dramatic increase in infections over four years. In 2017, there were 2.3 million new cases of chlamydia, gonorrhea, and syphilis, more than 200,000 from the previous year.

Since 2013, there has been a 67 percent increase in cases of gonorrhea, 15 percent among women but doubling in men. The principal concern here is that gonorrhea has become resistant to most antibiotics. The current treatment is an injection of ceftriaxone with an oral dose of azithromycin to prevent the bacterium from becoming resistant to ceftriaxone.

New studies from the CDC indicate that gonorrhea may well defeat this strategy. Gail Bolan, director of CDC’s Division of STD Prevention, warns: “We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed.”

Cases of primary and secondary syphilis went up 76 percent over four years. Even though there is mandatory syphilis testing for those women under prenatal care, far too few women with little or no medical attention get screened. The result, according to David Harvey, executive director of the National Coalition of STD Directors, is that “thousands babies a year are diagnosed with congenital syphilis.”

The most prevalent STD is chlamydia, and there were 1.7 million cases reported in 2017. The most troubling fact is that 45 percent of chlamydia infections were among young women 15-24.

In many cases chlamydia does not show any symptoms, and it is estimated that 25 percent of teen girls are living with an undetected STD. If chlamydia and gonorrhea remain untreated, women can, in some cases, become infertile.

The statistics in Idaho are equally troubling. In 2017, there were 6,577 reported cases of STDs, including HIV, up from 6,266 from the previous year. The number of cases vary from region to region. In Southeast Idaho gonorrhea infections were down 14 percent, but chlamydia was up slightly. In the South-Central Health District, however, instances of gonorrhea rose 203 percent.

Kimberly Matulonis-Edgar, STD Coordinator for the Idaho Department of Health and Welfare, speculates about the reasons for the increase: “It could be that people aren’t as consistently using condoms or not having conversations with their sexual partners. There are definitely more hook-up sites today than there were in the past, and people are having more anonymous sex than they have had in the past.”

These reasons may also explain the rise of STD infections in Europe, where, ten years ago, they were far fewer than the U.S. The increase is puzzling because these countries generally have much lower teen abortions, teen births, better sex education, and higher condom use.

In 2011, STD rates started to increase in the Netherlands after a conservative government cut funding for STD education and prevention. Nevertheless, the Dutch are far down the list of European countries with increased STD rates.

Sociologist Amy Schalet has done research comparing American and Dutch approaches to teen sexuality. She found that “most American teenagers hide their virginity loss from their parents, furtively popping the cherry in risky situations, often without protection against pregnancy or sexually transmitted infections. In contrast, most Dutch teenagers lose their virginity in their own bedrooms with their parent’s approval and condoms.”

Sweden has been named the “sexually transmitted infection capital of Europe.” In rank order, following the Swedes were Germans, Britons, French, Poles, Spaniards, Italians, and Danes, who acknowledged that they sought treatment for STDs. Sweden requires those who want treatment to both identify and inform all their sexual partners, so that authorities can more effectively counter this epidemic.

In 2016 Danish health authorities reported 34,132 cases of chlamydia, 3,478 gonorrhea infections (an increase of 27 percent), and 742 instances of syphilis. As a percentage of population, the total is just slightly less than the U.S.

Returning to Idaho, Heather Schaper, medical director at Health West in Pocatello, recommends that the state should be “offering more sex education that focuses not only on what STDs are but also safe practices at preventing them. Currently, Idaho public schools utilize an abstinence-only approach to sex education.”

Federal funding to prevent and treat STDs has decreased by 40 percent over the past 15 years, and STD prevention leader David Harvey has estimated that at least $70 million is needed immediately to address the STD epidemic in the nation.

Donald Trump once said that he was a “brave soldier” avoiding STDs. Vaginas were “potential landmines,” and it was his “personal Vietnam.” Let’s hope that he will see this as a national security issue.

Nick Gier of Moscow taught philosophy at the University of Idaho for 31 years. Email him at [email protected].